Care Plan (CP) Team Meeting (As updated during meeting) André Boudreau ([email protected]) Laura Heermann Langford ([email protected]) 2011-07-06 (No. 17) Care Plan wiki: http://wiki.hl7.org/index.php?title=Care_Plan_Initiative_project_2011 HL7 Patient Care Work Group To join the meeting: Phone Number: +1 770-657-9270 Participant Passcode: 943377 WebEx link is on the wiki (link below) With discussion notes and updates from the meeting
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Care Plan (CP) Team Meeting (As updated during meeting)
With discussion notes and updates from the meeting. To join the meeting: Phone Number : +1 770-657-9270 Participant Passcode : 943377 WebEx link is on the wiki ( link below ). Care Plan (CP) Team Meeting (As updated during meeting). André Boudreau ([email protected]) - PowerPoint PPT Presentation
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Care Plan (CP) Team Meeting(As updated during meeting)
• Minutes of June 22nd • Storyboard vetting process (André)• Storyboards
Note by Kevin on ‘Care Plan States’ (Kevin) Reviews: postponed to next meeting
• Models (Luigi)• Requirements (André)
Stakeholders expectations• Next meeting agenda
Page 3
Agenda for July 20th
• Minutes of July 6th • Storyboards- first draft
Stay healthy: Laura Home care SB resolution: André, Danny Perinatology: Laura Acute care: Kevin (Danny)
• Storyboard validation: identification of SME teams• Models (Luigi)
Resolve BPMN vs Activity diagram: feedback from SMEs Chronic care Home care
• Tentative Plan (André) Validation
• Next meeting(s) agenda
Page 4
Meetings During the Summer Period
• We will move to a meeting every second week until the end of August. Schedule is: July 20 August 3 August 17
o Review of Care plan functionalities in EHR-S FM R2 work by the HL7 EHR WG?
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Future Topics
• Review of EHR-S FM R2 work by the HL7 EHR WG: Aug. 17, tentatively John Ritter, Sue Mitchell, Pat Van Dyke, Lenel James
• Review of the ISO CONTSYS work on care plan aspects André to contact ISO Lead
• Care Plan elements from KP, Intermountain, VA, etc. (Laura)• Requirements (André)• Care Management Concept Matrix update (Susan)• EA Vs Eclipse: EA is preferred by many: Luigi, +++• Comparison of care plan contents (Ian, Laura)
To inform the information model Start of spreadsheet (Laura…)
• Overarching term to use (Ian M.)• Care Plan Glossary• Forward plan- first cut
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Participants- WGM Meetg of 2011-07-06 p1Name email Country Yes Notes
André Boudreau [email protected] CA YesCo-Lead- Care Plan initiative/HL7 Patient Care WG. B.Sc.(Physics), MBA. Owner Boroan Inc. Management Consultin. Chair, Individual Care pan Canadian Standards Collaborative Working Group (SCWG). Sr project manager. HL7 EHR WG.
Laura Heermann Langford [email protected] US Co-Lead- Care Plan initiative/HL7 Patient Care WG. Intermountain Healthcare. RN PhD,: Nursing
Informatics; Emergency Informatics Association, American Medical Informatics Association; IHE
Stephen Chu [email protected] AU NEHTA-National eHealth Transition Authority . RN, MD, Clinical Informatics; Clinical lead and Lead Clinical Information Architecture; co-chair HL7 Patient care WG; vice-chair HL7 NZ
Peter MacIsaac [email protected] AU HP Enterprise Services. MD; Clinical Informatics Consultant; IHE Australia; Medical Practitioner - General Practice
Adel Ghlamallah [email protected] CA Canada Health Infoway. SME at Infoway (shared health record); past architect on EMR projects
William Goossen [email protected] NL Results 4 Care B.V. RN, PhD; -chair HL7 Patient Care WG at HL7; Detailed Clinical Models ISO TC 215 WG1 and HL7 ; nursing practicioner
Anneke Goossen [email protected] NL Results 4 Care B.V. RN; Consultant; Co-Chair Technical Committee EHR at HL7 Netherlands; Member at IMIA NI; Member of the Patient Care Working Group at HL7 International
Ian Townsend [email protected] UK NHS Connecting for Health. Health Informatics; Senior Interoperability Developer, Data Standards and Products; HL7 Patient Care Co-Chair
Rosemary Kennedy [email protected] US Thomas Jefferson University School of Nursing . RN; Informatics; Associate Professor; HL7 EHR WG; HL7 Patient care WG; terminology engine for Plan of care;
Jay Lyle [email protected] US JP Systems. Informatics Consultant; Business Consultant & Sr. Project Manager
Margaret Dittloff [email protected] US The CBORD Group, Inc.. RD (Registered Dietitian); Product Manager, Nutrition Service Suite; HL7 DAM project for diet/nutrition orders; American Dietetic Association
Audrey Dickerson [email protected] US HIMSS. RN, MS; Standards Initiatives at HIMSS; ISO/TC 215 Health Informatics, Secretary; US TAG for ISO/TC 215 Health Informatics, Administrator; Co-Chair of Nursing Sub-committee to IHE-Patient Care Coordination Domain.
Ian McNicoll [email protected] UK Ocean Informatics . Health informatics specialist; Formal general medical practitioner; OpenEHR; Slovakia Pediatrics EMR; Sweden distributed care approach
Danny Probst [email protected] US Intermountain Healthcare. Data Manager
Kevin Coonan [email protected] US Yes MD. Emergency medicine. HL7 Emergency care WG.
Gordon Raup [email protected] US CTO, Datuit LLC (software industry).
Susan Campbell [email protected] US PhD microbiologist. Principal at Care Management Professionals. HL7 Dynamic Care Plan Co-developer
Elayne Ayres [email protected] US NIH National Institutes of Health. MS, RD; Deputy Chief, Laboratory for Informatics Development, NIH Clinical Center ; Project manager for BTRIS (Biomedical Translational Research Information System), a Clinical Research Data Repository
Agnes Wong [email protected] CARN, BScN, MN, CHE. Clinical Adoption - Director, Professional Practice & Clinical Informatics, Canada Health Infoway
Cindy Hollister [email protected] CA RN, BHSc(N), Clinical Adoption -Clinical Leader, Canada Health Infoway
Valerie Leung [email protected] CA Pharmacist. Clinical Leader, Canada Health Infoway
Luigi Sison [email protected] US YesInformation Architect at LOINC and at HL7. Enterprise Data Architect at VA. Developing standard for Detailed Clinical Models (DCM), information models for Electronic Health Record (EHR) Diabetes Project, etc.
Tom Kuhn Sr. Systems Architect at American College of Physicians
Mona ??? ??
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STORYBOARD VETTING PROCESS
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Storyboard (SB) Validation & Approval
• Clarify the guidelines and quality criteria for the Care Plan Storyboard (Care Plan Work Team CPWT)
• Assign a PCWT ‘owner’ for each SB (CPWT)• For each SB, identify a validation group (3 to 5) of SMEs that include
(CPWT) At least one physician, one nurse, and one other type of clinician that is
described in the SB Representation from at least 2 countries
• Obtain agreement to participate from SMEs (SB Owner)• Communicate the criteria and the specific SB to the appropriate group
of SMEs (SB Owner)• Obtain individual feedback from the SMEs (SB Owner)• Consolidate feedback and update the SB (SB Owner)• Review the updated SB with the SMEs and the CPWT at a regular
meeting (CPWT)• Finalize the SB (SB Owner)
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Care Plan Storyboard Guidelines and Quality Criteria• Focused on one typical story, not on exceptions• Focused on the exchange of information about care plan• Identifies what should be a best practice in the exchange of
clinical information• Is at the conceptual level, Is architecture, implementation and
platform independent• Is written in common clinical term, not in technical or IT terms
• Notes: Make explicit the state transitions? We will need to clarify the criteria for what is being sent in the information
exchange, especially for patients with a long history Exclude patient profile, referral request Do not exclude application services related to care plan information
exchange• SB SME? MnM, Lloyd, Graham
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Storyboard Owners
• Owners are coordinators for the preparation, review and approval of SB, not experts in the domain
• Home Care: André SMEs:
• Acute Care Plan Storyboard: Danny/Kevin SMEs:
• Perinatology: Laura SMEs:
• Pediatric and Allergy/Intolerance: Susan SMEs:
• Stay healthy: Laura SMEs:
Page 12
STORYBOARDS
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Care Plan States: Note by Kevin Coonan
• The Care Plan and the Health Concern share a similar issue about state management, and how it gets updated between providers involved with care of a mutual patient.
• Both an instance of a Health Concern and a Care Plan need well prescribed use of the Act state machine (along with the associated specific transitions, which need to be part of the picture) to do this. We need to be very explicit in our use cases and stories about when the status of a plan/problem is updated, and how that update is communicated to others. The static semantics isn't the issue here (thankfully), but the interactions are. This is going to be different in enterprises (which can assume a single broker of Health Concern and Care Plan status, and manage updates to it, as well as record the history of updates) v. a loose federation (which may have some mechanism to pass messages/updates) v. a bunch of separate EHRS which need to exchange content (esp. if in the form of CDA r2, as there is no mechanism to handle status updates other than generating a new document instance).
• An order (ActRequest) is something that also has state, and needs to be managed by an order entry system. The details of how the order entry system makes its own sausage is out of scope for the Care Plan topic. The order state is not going to always agree with the care plan state. Care Plan/Health Concern state is pretty easy.
• We have to call this out, as well as how interactions between systems/providers are managed to be sure the assumptions are explicit, so that we can be sure that we have a representative set when it comes time to define messages, documents, and services. As long as we are careful to make this explicit in use cases, things will be OK. It is just when we make assumptions about updating EHRSs we will get into trouble.